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When starting the elimination diet, the variety of food the patients with EoE is allowed to eat is very much limited. The most practised diet is the 6 food elimination diet (eggs, soya, wheat, fish, nuts and dairy), however there is also another diet even more restrictive that also eliminates legumes, rice, corn, and the rest of cereals with gluten such as rye, barley and oats. Therefore, in this last diet the intake consists of fruits, vegetables, meats.

Although the individual is allowed to eat meat, this should not be processed as some meat products such as chorizo, bacon, boiled ham… etc, normally contain milk derivatives, starches (from corn, wheat or rice), soya and its derivatives…etc. However, serrano ham or Iberian ham is usually free of allergens, and consequently could be included in the diet. Always double check the labelling.

Due to the severity of this diet, above all at the beginning one should find a suitable method of ingesting foods that provide enough energy. Tubers such as potatoes, sweet potatoes or yucca have complex carbohydrates, which provide energy and at the same keep sugar levels in the blood stable. In addition, they provide minerals and contain high amounts of vitamin B.

One of the main difficulties when following this diet comes with t breakfast. It is not possible to eat dairy products, eggs, cereals, bread, cookies, or any other kind of pastries. Most of these common items as most breakfast tables around the world. Thus, bananas can be a good substitute since it is one of the fruits that provide a more calorie dense intake. The avocado is also a fruit that provides a high level of energy, contains healthy fats such as omega 3 and 6 and vitamins.

Regarding substitutes for milk and ​vegetable milks such as almond, rice, oat or soya milks, it is possible to opt for tiger nut milk as tiger nuts are tubers, but always check whether potential allergens have been added.

Finally, a good alternative to cereals are teff and quinoa. Both gluten free and in spite of corn and rice are also gluten free, the intake of teff and quinoa has been non-existing during the past years and currently no so many people consume them, so that’s why there is no reaction expected.

About The Author

Alfredo J Lucendo, MD, PhD, serves as gastroenterologist at Tomelloso General Hospital, Spain. He is author of relevant research in the field of gastrointestinal diseases with an especial interest in EoE.

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ORGANIZATIONS INVOLVED

EOElink is part of the UEG Link-Award Project called “Harmonizing the diagnosis and therapy of EoE across Europe” (or HAEoE-EU), a research initiative supported by the United European Gastroenterology and developed by the Spanish Society of Digestive Diseases in association with other 13 European Scientific Societies.